HCA Healthcare UK The Harborne Hospital

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated Good. This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The service was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. This commenced in the outpatient department when treatment options were discussed and agreed with the patient and the consultant. In the oncology service patients concerns, views and options were always discussed and patients told us that they felt empowered to chose care options. In endoscopy the lead contacted all patients to discuss treatment with them. Giving them time to review the information they had sent and discussed this and new information with them. The endoscopy lead offered an opportunity for patients to ask questions and express any concerns. Generally, these were around the discomfort of the procedure. The endoscopy lead explained that whilst the team would do everything that they could to lessen the discomfort the patient had options. They explained the benefits and challenges of these options to patients. One patient who had had a number of different complications explained to us that they and their loved ones had been consulted at every stage and that they felt that decisions were made with them.

Staff understood the diverse health and care needs of people and their local communities, so care was mostly joined-up, flexible and supported choice and continuity. The senior leadership team had opened the hospital by targeting a small number of specialities for which there was a lack of provision in the local area. They recruited specialists in these fields to provide good care, treatment and support to patients. The hospital worked with third parties to support the internal service offering and in general this worked well. However, one patient told us, and we saw from patient surveys that sometimes access to advice and support post discharge was difficult. Whilst the nursing team tried to have a member of each speciality on duty at any one time this was not always achievable, and patients noticed when nursing staff were not dedicated to their particular service. Senior leaders were aware of this issue and were recruiting further staff and had plans to have designated staff and space for some specialities. However, this had yet to be achieved. Despite this we saw good working relationships internally which led to good patients handovers between care providers.

The service had appropriate, accurate and up to date information in formats that were tailored to the needs of their patients. Staff had access to an online platform which could produce most patient information leaflets. At outpatient assessment consultants discussed procedures and treatment options and produced information for patients. On booking a procedure patients were sent appropriate information about the hospital and their treatment for them to read prior to treatment. Prior to admission staff checked that patients had all the information they required and answered any questions patients may have. On discharge patients were mainly offered further information. Senior leaders recognised that some consultants preferred their own information to be given to patients and were looking at the option of supplementing the current supply with individual consultant information and videos. Information was available in different languages and formats but this option was not often required by the patients at the hospital.

The service made it easy for patients to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result. Patients were provided with a questionnaire for feedback on discharge. This was fed into a computer system which enabled staff to see feedback in a timely manner. Issues raised whilst patients were in hospital were dealt with at source and reviewed by senior leaders. The senior team would visit patients who had made complaints to fully understand the issue and seek to resolve it. There had been no formal complaints about the inpatient medical service since it commenced. Senior staff were aware that the majority of informal and complaints about other services were about access and information. There were plans in place to work more closely with medical secretaries who were responsible for access to the hospital.

Staff made sure that people could access the care, support and treatment they needed when they needed it. All staff were committed to ensuring equitable access, outcomes, and experiences for all patients, including those with learning disabilities (LD), autism, dementia, and mental health needs. This commitment was embedded in the mission statement of the hospital to provide care that is unique and individual. This was supported in several ways including, hospital patient passports used to capture essential information about a patients needs, reasonable adjustments such as extended appointment times and quiet areas, a flagging system on the electronic system to ensure that all staff were aware of any reasonable adjustments necessary, initiatives to reduce overmedication of people with a learning disability and autism. These initiatives were supported with Makaton signs in reception, Hearing Loop systems, access to language line and two multifaith prayer rooms. Staff completed Oliver MacGowan training to support people who were vulnerable.

There was a 24-hour helpline that patients could call following treatment. The phone was held by a member of the clinical team, usually the person in charge of the ward. They could arrange to speak with the patient’s consultant, the resident medical doctor or whomever is best placed to advise the patient. Patients could return to the hospital to be seen or reviewed by a medic. The resident medical doctor was available 24-hours a day to patients if they needed medical review. Staff made reasonable adjustments for patients who needed these. Relatives or carers could stay with the patient if required. Discharges were planned with patients, carers and others as necessary. Discharges were undertaken at a time that suited the patients and their family

As described above staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Staff received training in equality, diversity, inclusion and human rights. We heard an example of how staff responded to patients and their carers without prejudice but respected people and empowered them to be partners in care. Staff promoted a culture in which people using the service felt empowered to give their views.

People were supported by planning for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Staff in the oncology day unit and the clinical nurse specialist helped patients living with cancer to think about the future and to plan for this. The team worked with Supportive Care Uk and had a palliative care nurse on site 2 to 3 days a week as necessary. There were several nurses with advanced training in oncology who supported patients and worked between the oncology day unit and the ward to ensure that patients felt supported in either environment. Patients wishes as to future treatment were recorded. There was a resident medical doctor for oncology available four days a week.